Peginterferon alfa-2a

Peginterferon alfa-2a Overview

Updated: April 1, 2015

Peginterferon alfa-2a is a prescription medication used to treat hepatitis B and also to treat chronic (lasting a long time) hepatitis C infection in people who have not taken alpha interferon. Peginterferon alfa-2a belongs to a group of drugs called interferons. It works by activating the body's immune system to attack hepatitis viruses.

This medication comes in an injectable form in a prefilled syringe and is given just under the skin. It is usually given once a week, for up to 48 weeks.

Common side effects of peginterferon alfa-2a are flu-like symptoms, tiredness, and stomach problems.

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Peginterferon alfa-2a Drug Class

Side Effects of Peginterferon alfa-2a

1. Blood problems. Peginterferon alfa-2a can affect your bone marrow and cause low red blood cell, low white blood cell and platelet counts. In some people, these blood counts may fall to dangerously low levels. If your blood cell counts become very low, you can get anemia, infections or have problems with bleeding and bruising.

2. Thyroid problems. Some people develop changes in the function of their thyroid. Symptoms of thyroid changes include feeling cold or hot all the time, a change in your weight, and changes to your skin, trouble concentrating.

3. Blood sugar problems. Some people may develop high blood sugar or diabetes. If you have high blood sugar or diabetes before starting peginterferon alfa-2a, talk to your healthcare provider before you take peginterferon alfa-2a. If you develop high blood sugar or diabetes while taking peginterferon alfa-2a, your healthcare provider may tell you to stop peginterferon alfa-2a and prescribe a different medicine for you.

Symptoms of high blood sugar or diabetes may include:

Increased thirst

Tiredness

Urinating more often than normal

Increased appetite

Weight loss

Your breath smells like fruit

4. Serious eye problems. Peginterferon alfa-2a may cause eye problems that may lead to vision loss or blindness. You should have an eye exam before your start taking peginterferon alfa-2a. If you have eye problems or have had them in the past, you may need eye exams while taking peginterferon alfa-2a. Tell your healthcare provider or eye doctor right away if you have any vision changes while taking peginterferon alfa-2a.

new or worse high blood pressure of the lungs (pulmonary hypertension). This can be severe and may lead to death. You may need to have a chest X-ray or other tests if you develop fever, cough, shortness of breath or other symptoms of a lung problem during treatment with peginterferon alfa-2a.

10. Nerve problems. People who take peginterferon alfa-2a or other alpha interferon products with telbivudine (Tyzeka) for hepatitis B can develop nerve problems such as continuing numbness, tingling, or burning sensation in the arms or legs (peripheral neuropathy).

11. Effect on growth in children. Children can experience a delay in weight gain and height increase while being treated with peginterferon alfa-2a and ribavirin. Catch-up in growth happens after treatment stops, but some children may not reach the height that they were expected to have before treatment. Talk to your healthcare provider if you are concerned about your child’s growth during treatment with peginterferon alfa-2a and ribavirin.

Call your healthcare provider if you have any of these symptoms. Tell your healthcare provider right away if you have any of the symptoms listed above.

The most common, but less serious side effects of peginterferon alfa-2a include:

flu-like symptoms. Symptoms may include: fever, chills, muscle aches, joint pain, and headaches. Some of these symptoms may be decreased by injecting your peginterferon alfa-2a dose in the evening. Talk to your healthcare provider about which over-the-counter medicines you can take to help prevent or decrease some of the symptoms.

tiredness and weakness. Many people become very tired or feel weak while taking peginterferon alfa-2a.

stomach problems. Nausea and vomiting may happen with peginterferon alfa-2a.

loss of appetite

skin reactions. Some people may develop redness, swelling, dry or itchy skin at the site of injection. If after several days these symptoms do not disappear, contact your healthcare provider.

hair thinning. Temporary hair loss is not uncommon during treatment with peginterferon alfa-2a.

trouble sleeping

Peginterferon alfa-2a Interactions

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Peginterferon alfa-2a and certain other medicines may affect each other and cause side effects. Especially tell your healthcare provider if you take:

Peginterferon alfa-2a Precautions

have had a serious allergic reaction to another alpha interferon medicine or to any of the ingredients in peginterferon alfa-2a. Symptoms of a serious allergic reaction to alpha-interferon may include: itching, swelling of your face, tongue, throat, trouble breathing, feeling dizzy or faint, and chest pain.

Do not take peginterferon alfa-2a in combination with ribavirin if you:

are pregnant, or planning to get pregnant during treatment or during the 6 months after treatment

are a male patient with a female sexual partner who is pregnant or plans to become pregnant at any time while you are being treated with ribavirin or during the 6 months after your treatment has ended

have certain blood disorders such as thalassemia major or sickle-cell anemia

Do not give peginterferon alfa-2a to a baby under 1 year of age. Peginterferon alfa-2a contains benzyl alcohol. Benzyl alcohol can cause nervous system problems and other problems which may lead to death.

Do not drink alcohol, including beer, wine and liquor while taking peginterferon alfa-2a. This may make your liver disease worse.

Peginterferon alfa-2a Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of peginterferon alfa-2a there are no specific foods that you must exclude from your diet when receiving peginterferon alfa-2a.

Peginterferon alfa-2a and Pregnancy

If you are pregnant do not start taking or continue taking peginterferon alfa-2a alone or in combination with ribavirin. Ribavirin in combination with peginterferon alfa-2a may cause birth defects or death of your unborn baby.

Avoid becoming pregnant while taking peginterferon alfa-2a, alone or in combination with ribavirin. Peginterferon alfa-2a, alone or in combination with ribavirin, may harm your unborn child (death or serious birth defects) or cause you to lose your baby (miscarry).

Do not switch to another brand of interferon without talking to your healthcare provider

Take your prescribed dose of peginterferon alfa-2a1 time each week, on the same day of each week and at approximately the same time.

Do not take more than your prescribed dose.

If you miss your dose

If you remember within 2 days of when you should have taken peginterferon alfa-2a, give yourself an injection of peginterferon alfa-2a as soon as you remember. Take your next dose on the day you would usually take it.

If more than 2 days have passed, ask your healthcare provider what you should do.

Your healthcare provider should show you how to prepare and measure your dose of peginterferon alfa-2a, and how to inject yourself before you use peginterferon alfa-2a for the first time.

The recommended dose of peginterferon alfa-2a when used in combination with ribavirin for chronic hepatitis C is 180 mcg (1 mL vial, 0.5 mL prefilled syringe or 0.5 mL disposable autoinjector) once weekly. The recommended dose of ribavirin and duration for peginterferon alfa-2a/ribavirin therapy is based on viral genotype.

The daily dose ribavirin is 800 mg to 1200 mg administered orally in two divided doses. Ribarvirin should be taken with food.

Peginterferon alfa-2a is administered as 180 mcg/1.73 m2 × BSA subcutaneously once weekly, to a maximum dose of 180 mcg, and should be given in combination with ribavirin. The recommended treatment duration for patients with genotype 2 or 3 is 24 weeks and for other genotypes is 48 weeks.

Ribavirin is available only as a 200 mg tablet and therefore the healthcare provider should determine if this sized tablet can be swallowed by the pediatric patient. Ribavirin should be administered with food. The recommended doses for ribavirin is based on body weight. The dose range is 400 mg to 1200 mg daily (divided doses). Patients who initiate treatment prior to their 18th birthday should maintain pediatric dosing through the completion of therapy.

The recommended dose when used in combination with ribavirin is peginterferon alfa-2a 180 mcg once weekly and ribavirin 800 mg orally daily given in two divided doses for a total of 48 weeks, regardless of genotype.

Since ribavirin absorption increases when administered with a meal, patients are advised to take ribavirin with food.

Peginterferon alfa-2a FDA Warning

Alpha interferons, including peginterferon alfa-2a, may cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Patients should be monitored closely with periodic clinical and laboratory evaluations. Therapy should be withdrawn in patients with persistently severe or worsening signs or symptoms of these conditions. In many, but not all cases, these disorders resolve after stopping peginterferon alfa-2a therapy.

Use with Ribavirin

Ribavirin, including Copegus, may cause birth defects and/or death of the fetus. Extreme care must be taken to avoid pregnancy in female patients and in female partners of male patients. Ribavirin causes hemolytic anemia. The anemia associated with ribavirin therapy may result in a worsening of cardiac disease.

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